Heart attacks are commonly associated with warning signs such as chest pain, breathlessness, or arm discomfort. But cardiologists say this perception can be dangerously misleading. In reality, many heart attacks occur without any symptoms at all, striking people who felt completely healthy moments before the event.
Doctors are now urging adults to consider early screening for hidden heart disease using a simple test known as coronary calcium scoring. The scan, which takes about five minutes, can reveal dangerous plaque build-up in the coronary arteries years before it triggers a heart attack.
“Many patients who suffer heart attacks have never experienced chest pain or any warning symptoms,” said Dr Adil Rizvi, medical director and cardiothoracic surgeon at RAK Hospital. “When heart disease is silent, waiting for symptoms can be dangerous. Early detection allows us to intervene before disaster strikes.”
Coronary calcium scoring uses a low-dose CT scan to detect calcium deposits in the arteries supplying blood to the heart. These deposits indicate atherosclerosis, a slow and silent process in which plaque narrows the arteries over time and can suddenly rupture, causing a heart attack.
Unlike many medical tests, the scan is non-invasive and does not require injections, contrast dye, needles, or recovery time. While the full appointment may take up to 30 minutes, the scan itself lasts only a few minutes.
Dr Austin Mohan Komaranchath, head of cardiology at NMC Specialty Hospital in Al Ain, said heart disease often affects people who appear fit and active. “I frequently see patients who exercise regularly and feel healthy but still have significant plaque in their coronary arteries,” he said.
He explained that intense exercise or heavy lifting can cause sudden spikes in blood pressure, increasing the risk of plaque rupture. “I have seen relatively young individuals suffer acute heart attacks with no prior symptoms,” he added.
Standard tests such as ECGs and blood work may fail to detect long-term artery damage. “ECGs mainly show electrical problems, while blood tests reflect current inflammation,” said Dr Madhujith Padinharakara, specialist radiologist at International Modern Hospital in Dubai. “They do not reveal gradual narrowing of the arteries over many years.”
Calcium scoring fills this gap by identifying silent structural heart disease. Studies show that higher calcium scores are strongly linked to future heart attack risk, while a score of zero usually indicates low short- to medium-term risk.
Doctors recommend the scan for adults over 40 and for younger individuals with risk factors such as high blood pressure, diabetes, high cholesterol, smoking, obesity, or a family history of heart disease.
“Prevention doesn’t always require complex procedures,” said Dr Rizvi. “Sometimes, it starts with a simple scan that helps you act before it’s too late.